摘要
内眦赘皮是位于内眦角前方一片呈斜向或垂直向分布的半月形皮肤蹼状皱襞。内眦赘皮与种族差异有着密切的联系，最常见于中亚、北亚、东亚等地区的蒙古人种中，故又称“蒙古皱襞”。其中在中国人中占有率为50％左右，而在韩国和日本人中甚至达到了50％—90％。单睑人群占有率在70％以上。其特征为正常内眦角常被赘皮掩盖。赘皮遮挡部分视线，有时造成假性内斜视，睑裂变短，两内眦间距显宽，如果是重睑，也会因为赘皮遮盖而成为“半双”，有碍眼外形美观。
本文由文献综述和临床应用两部分组成。
文献综述部分通过检索国内外相关文献，总结和回顾了内眦赘皮的形成原因、相关的解剖学研究、以及内眦赘皮的分类、分度和手术治疗方法。
临床上，我们总结和回顾了1999年以来收治的1370例内眦赘皮患者，对其外形和术中解剖结果进行总结；根据内眦赘皮的成因而将其分为上睑型、下睑型和上下睑型，根据其遮盖泪阜的程度而分为轻、中和重度。均采用张海明法、Park法或Mustarde法矫正，或同时行重睑成形术。术后有294例患者接受长期随访，随访时间为6至38个月。我们认为，上睑型和上下睑型可用张海明法或Park法矫正，下睑型和上下睑型可用Park法或Mustarde法矫正。在随访的294例患者中，完全纠正者264例，30例部分矫正。手术结果满意。
The medial epicanthal fold is formed by an excess of skin that lies in a vertical,semilunar orientation, located at the medial canthus and overlying the medial canthalstructures. It has close relationship with racial difference. It exists in Mongolian inCentral Asia, North Asia and East Asia mostly, so it is also called "mongoloid fold". Itexists in more than one half of the Chinese and in 50 to 90 percent of Koreans andJapanese. And more than 70 percent of foldless eyelid combines the medialepicanthal fold. The characteristics are that the medial canthal corner is often coveredby the epicanthus. The severe epicanthal fold hides part of the sight, which looks likepseudoesotropia in appearance, makes the palpebral fissure shorter, and makes themedial canthal distance longer. If the double eyelid exists with the epicanthus, theepicanthus will make the double eyelid "semi-double" in appearance, which is anunpleasant look.
This thesis is composed of two parts: reviewing the literature on the formationand the surgical correction of the epicanthus and the clinical application of theepicanthoplasties with their long-term follow-up.
In our summary, we reviewed the literature and summarized the correspondinganatomical studies, the formation cause of epicanthus, the classification andgraduation of epicanthus, varied methods to correct the epicanthic fold. And especially,the newest progression and the prospective of above-motioned aspects in recent yearswere discussed in our summary.
On the basis of the investigation on the 1370 cases of epicanthi that weretreated in late 8 years, the relationship between the epicanthal appearances andanatomical dissection in surgery was summarized. All the epicanthi were corrected byZhang's procedure, Park's procedure or Mustarde's procedure, or with a concomitantdouble eyelidplasty. 294 cases were followed up in long-term and the follow-up timewas 6 months to 38 months. According to the epicanthal formation, they wereclassified into three types: upper-eyelid type (corrected by Zhang's or Park'sprocedure), lower-eyelid type (corrected by Mustarde's or Park's procedure), or upper-lower-eyelid type (corrected by Zhang's or Park's procedure). According to thedegrees to cover the carruncula, the epicanthi were divided into the mild, the moderateor the serious. 294 cases were followed up in long-term time from 6 months to 38months, of which, 264 cases were corrected completely and 30 cases were correctedincompletely. The incision scar faded 2-6 months later. The appearance of the medialcanthi and the double eyelids were natural.
引文
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10．宋建星，孙美庆，陈江萍，等。东方人内眦赘皮的解剖及治疗。中华医学美学美容杂志，2001，7(5)：251-253。
11．赵宏武，卢范，宋建星。内眦赘皮的解剖成因探究。中国美容医学。2001，10(3)：176—177。
12．张余光，杨群，汪希，等。眼轮匝肌的解剖结构和力学方向对上睑形态的影响。中国实用美容外科杂志，2004，15(2)：70-72．
13. Stallard HB :Eye Surgery. Baltimore :Williams &Wiikins, 1950.
14. Spaeth, E. B. The Principles and Practices of Ophthalmic Surgey. Philadelphia:Lea&Febiger, 1934.
15. Spaeth, E. B. Further consideration of surgical correction of blepharophimosis and epicanthus. Am. J. Ophthalmol.1956, 41: 61.
16. Spaeth, E. B. Further consideration of surgical correction of blepharophimosis and ptosis. Arch Ophth. 1964, 71:510.
17. Yoon K. Modification of Mustarde technique for correction of epicanthus in Asian patients. Plast Reconstr Surg, 1993,92(6):1182-6.
